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Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Total and differential leucocyte counts were performed on 175 patients with a provisional diagnosis of acute appendicitis. Ninety-six per cent of patients with acute appendicitis had either an abnormal total or differential leucocyte count. Four of 24 patients operated on with a normal leucocyte count had acute appendicitis. It is concluded that leucocytosis of above 10 000/mm3 or a differential in excess of 75% neutrophils supports the clinical diagnosis of acute appendicitis and that routine estimation of the leucocyte count is a useful investigation. While a normal leucocyte count does not exclude even a perforated appendicitis, such a count should prompt further review of the diagnosis, especially in the presence of an atypical history or minimal physical signs.
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PMID:The value of the leucocyte count in the diagnosis of acute appendicitis. 125 16

Twelve children with acute abdominal pain, which was suspected of being acute appendicitis, were subsequently found to have lower lobe pneumonia. Diagnostic barium enema or operative exploration failed to demonstrate any appendiceal abnormality. The abdominal symptoms and the ileus subsided soon after the initiation of antibiotic therapy. Contrary to common belief, it was observed that left-sided pneumonia is capable of mimicking appendicitis almost as frequently as right-sided pneumonia. Since the likelihood of acute appendicitis accompanying pneumonia is small, operative intervention is rarely indicated and should be undertaken only after careful and intensive investigation.
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PMID:Basilar pneumonia simulating acute appendicitis in children. 126 2

Ninety two children aged up to 3 years and operated upon for acute appendicitis were observed. The clinical picture of appendicitis is described, and some diagnostic difficulties are noted. The mortality due to appendicitis in this group of patients was 15.2%.
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PMID:[Acute appendicitis in young children]. 127 22

A two year review of 216 patients with a preoperative diagnosis of appendicitis is used to help clarify the continuing points of controversy concerning appendicitis. Morbidity of perforated appendicitis by far exceeds that of nonperforated cases. Twenty-nine per cent of patients had perforation with a postoperative complication rate of 33 per cent. Rate of wound infection after perforation was 15 per cent despite antibiotics and delayed wound closure. Pediatric patients in this study did not experience a higher incidence of perforation or complication. A decision tree for management of acute appendicitis is presented.
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PMID:The continuing challenge of acute and perforated appendicitis. 127 38

Twelve patients who underwent laparotomy for suspected acute appendicitis were found to have Crohn's disease of the terminal ileum. Appendectomy was performed in all although in only four patients was the appendix grossly inflamed. Postoperative complications, either abscess or fistula, developed in four patients (33%). Careful investigation of the records revealed some preoperative diagnostic clues: a history of recurrent abdominal pain and/or diarrhea (83%), physical examination revealing normal temperature (50%), and laboratory results compatible with a chronic process such as microcytic anemia (33%) and hypoproteinemia/hypoalbuminemia/hypocholesterolemia (50%). As the differential diagnosis between Crohn's disease and appendicitis is difficult and the surgical approach to the appendix in the presence of Crohn's disease is controversial, we illuminate some practical points in the preoperative evaluation of these patients and deal with the question of whether appendectomy should be performed in these patients.
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PMID:Preoperative clues to Crohn's disease in suspected, acute appendicitis. Report of 12 cases and review of the literature. 129 36

An analysis of clinical effectiveness of antibacterial therapy, photomodification of autoblood, hemosorption and their combinations was made in 395 patients with acute appendicitis. It was established that no antibacterial and desintoxicating therapy is required in catarrhal appendicitis. The prophylactic application of photomodification of autoblood is thought to be most expedient for phlegmonous appendicitis at the postoperative period, a combination of antibacterial therapy and photomodified autoblood--for gangrenous appendicitis, a combination of antibacterial therapy, photomodification of autoblood and hemosorption--for appendicular diffuse suppurative peritonitis.
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PMID:[Antibacterial and detoxification therapy in acute appendicitis]. 133 27

From February 1990 to December 1991, 16 laparoscopic procedures were performed for right lower quadrant pain. There were nine men and seven women, aged 16 to 47 years (mean, 27.2 years). All procedures were performed by surgical chief residents with prior experience in laparoscopic cholecystectomy, first-assisted by an attending surgeon. The appendix was visualized and a definitive diagnosis was made in all patients. One patient with acute salpingitis underwent diagnostic laparoscopy only; two patients underwent laparotomy (perforated appendicitis, perforated diverticulitis). A fourth patient had an acute torsion of an ovarian cyst managed laparoscopically. Laparoscopic appendectomy was successfully performed in 12 patients (acute appendicitis, 9; fibrosis or chronic inflammation, 2; normal appendix, 1). Mean operative time for laparoscopic appendectomy was 95.7 minutes, and mean postoperative stay was 2.5 days. The authors conclude that operative time, diagnostic accuracy, and complication rates for laparoscopic appendectomy are acceptable. Within the context of a training program, laparoscopic appendectomy provides an opportunity for surgical residents to expand laparoscopic skills.
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PMID:Laparoscopic appendectomy. Initial experience in a teaching program. 138 42

We had a 20% rate of negative appendectomies in our patients presenting with suspected appendicitis. We suggested that an improved clinical examination would reduce this rate. 84 consecutive patients presenting with suspected acute appendicitis were prospectively studied. 10 clinical features were used to calculate a score which should distinguish appendicitis and non-specific abdominal pain. 53 appendectomies with 6 (11.3%) perforations, 41 (77.4%) acute inflammations and 6 (11.3%) normal appendixes have been performed. 26 patients suffered from non-specific abdominal pain, 5 had an other surgical disease. In the appendectomized patients the score was 4.2 +/- 1.2 with perforation, 4.4 +/- 1.1 with acute inflammation and 3.8 +/- 1.3 with a normal appendix (p = ns). The score for non-specific abdominal pain in patients without operation was significantly lower (2.0 +/- 1.1; p less than 0.01). Patients with other surgical disease had a score of 2.8 +/- 1.5 with no significant difference to patients which had undergone appendectomy. Negative appendectomies were reduced by improved clinical examination from 20.3% to 11.3% without change in the rate of perforation. The remaining patients with negative appendectomies could not be identified by improved clinical examination even by means of the score. But the use of the score improved the performance of the clinicians.
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PMID:[Negative appendectomies can be decreased by improved clinical assessment alone]. 138 95

The application of laparoscopy for diagnosis and treatment of the acute abdomen, appendicitis, and in the management of small and large bowel diseases is a natural step for the general surgeon. Acute appendicitis is a common general surgical problem that can be difficult to diagnose. Laparoscopy is an excellent aid in diagnosis and laparoscopic appendectomy can be performed easily. The controversy of incidental appendectomy and recommendations for management are discussed. Small and large bowel diseases and their surgical treatment now can be managed laparoscopically thus decreasing morbidity and mortality. The uses and limitations of these techniques are discussed as well as future trends in treatment.
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PMID:Laparoscopic management of the acute abdomen, appendix, and small and large bowel. 138 4

The diagnosis of acute appendicitis is still difficult to ascertain in children. However, a complete anamnesis, an accurate physical examination as well as a careful evaluation of other medical and surgical possibilities causing abdominal pain allow to arrive to a correct diagnosis in 80% of cases. Laboratory findings may be helpful but usually don't add further information. Each patient suspected to have appendicitis should be admitted to the hospital and kept under observation; if no improvement is registered during the following hours then a surgical exploration is needed. The surgeon, however, must be acquainted with the different medical affections causing abdominal pain in order to decide whether a laparotomy is required. The Authors report their experience in 426 patients submitted to appendectomy and stress the correlation between abdominal pain and intraoperative finding.
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PMID:[Acute abdominal pain and appendicitis in childhood]. 138 86


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